Combined use of Chinese medicine with allogeneic hematopoietic stem cell transplantation for severe aplastic anemia patients / 中国结合医学杂志
Chinese journal of integrative medicine
; (12): 903-909, 2014.
Article
de En
| WPRIM
| ID: wpr-310885
Bibliothèque responsable:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To determine the effect of combined treatment with Chinese medicine (CM) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) on patients with severe aplastic anemia (SAA).</p><p><b>METHODS</b>Eleven patients were treated with CM plus allo-HSCT. Nine patients received a conditioning regimen consisting of fludarabine (Flu), anti-thymocyte globulin (pig ALG), or anti-lymphocyte globulin (Rabbit ATG) and cyclophosphamide (CY), and two patients received pig ALG and CY. All patients were treated with Kidney (Shen)-reinforcing, blood-activating, and stasis-removing (KBS) herbal preparation beginning at 1 week before transplantation and ending at 8 weeks after transplantation. Chimerism status was assessed by analyzing short tandem repeat (STR) polymorphisms.</p><p><b>RESULTS</b>All patients recovered hematopoietic function and none had graft failure. The median number of days required for the absolute neutrophil count (ANC) increased to >0.5×10(9)/L was 15 days (12-22 days) and for spontaneous platelet recovery to >20×10(9)/L without post-transplantation transfusion was 17 days (15-27 days). Nine patients were long-term survivors and achieved full donor chimerism. The overall cumulative incidence of acute graft versus host disease (GVHD) grades I-II and III-IV was 18.2% (2/11) and 9.1% (1/11), respectively. The overall accumulated incidence of chronic GVHD was 27.3% and all patients had limited chronic GVHD. At a median follow-up time of 32 months (range: 12-97 months), 9 patients were still alive. The estimated 5-year overall survival (OS) rate was 81.8%. The incidence of treatment-related mortality, 2-year post-transplantation, was 18.2%. Two patients died from GVHD after transplantation.</p><p><b>CONCLUSION</b>Treatment with the KBS formulation may reduce the rate of graft failure and treatment-related mortality and improve the rate of OS in SAA patients with allo-HSCT.</p>
Texte intégral:
1
Base de données:
WPRIM
Sujet principal:
Syndrome
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Thérapeutique
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Transplantation homologue
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Médicaments issus de plantes chinoises
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Résultat thérapeutique
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Association thérapeutique
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Transplantation de cellules souches hématopoïétiques
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Sus scrofa
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Utilisations thérapeutiques
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Estimation de Kaplan-Meier
Limites:
Animals
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Female
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Humans
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Male
Langue:
En
Journal:
Chinese journal of integrative medicine
Année:
2014
Type de document:
Article